Venereal disease in the male homosexual population has been well studied, but little information is available about venereal disease in lesbians. A screening of 148 sexually active lesbians revealed no cases of syphilis, cervical gonorrhea, herpes simplex virus, or Chlamydia trachomatis infections. Cervical atypia, ranging from mild dysplasia to carcinoma in situ, was detected in four women (2.7%). This group of lesbians had a longer mean interval between routine Papanicolau smears (21 months) than did other women using the same clinic facility (eight months). Results indicate that routine screening for venereal disease may not be cost-effective in a lesbian population, but routine Papanicolau smears should be encouraged.